Alumnus helps establish Kenya’s first family medicine residency program
Bruce Dahlman’s first taste of international medicine, when he was a medical student in 1980, lingered, took hold, and eventually lured him back.
Between his third and fourth years at the University of Minnesota Medical School, Dahlman visited several African countries to observe community health care there. Two things stuck with him long after he returned to the United States: the “breathtaking” scenery and the camaraderie of national and expatriate health-care workers serving together at a hospital in Zaire called Nyankunde.
“I came away from that experience thinking, ‘This is something God might have me do someday,’” says Dahlman, Medical School Class of 1981.
So far, Dahlman has spent about half of his 25-year-career seeing patients and teaching future doctors at African Inland Church Kijabe Hospital in Kenya, part of an evangelical Christian ministry.
And in 2005, he and his colleagues launched Kenya’s first family medicine residency program—also one of the first such programs in East Africa.
After eight years in family medicine in Grand Marais, Minnesota, Dahlman moved to Kenya with his family in December 1992. As one of six doctors at a 200-bed hospital, he immediately felt the need for more doctors in Kenya, where the doctor-to-population ratio is 1 to 8,000.
The doctors also needed more training, Dahlman realized. After medical school, Kenyan doctors then typically participated in just one year of rotating internships—in internal medicine, pediatrics, obstetrics, and surgery—before they were assigned to a district hospital practice.
“Many received very little hands-on training,” Dahlman says. “They’d be sent out to perform C-sections and emergency surgeries without having consolidated their skills, some never having performed the surgery.”
The shortage of well-trained doctors is especially apparent in rural areas of the country. Approximately 70 to 80 percent of Kenyans live in rural areas, but only 16 to 20 percent of Kenyan doctors practice there.
Dahlman hoped a family medicine residency program could bridge the gaps between the city and rural areas. Like the training offered at the Medical School’s Duluth campus—where Dahlman completed his first two years of medical school—this program encourages doctors to take their skills to rural areas.
“People in Kenya understand the need to serve the people of their country, even when it involves a personal sacrifice,” Dahlman says. “Those providing health care face extremely difficult situations—supplies running out, drugs running out, technology not working—yet these people persevere.”
Dahlman, who moved back to Minnesota in 1995 and worked as assistant director of the Duluth Family Practice Residency program while his wife earned a master’s degree in nursing at the University, became familiar with problem-based learning and curriculum writing when he worked for the Medical School.
Upon his return to Kenya in 2000, Dahlman partnered with two other family physicians and two faculty members at Moi University Faculty of Health Sciences in Eldoret, Kenya, to define the role of these new family medicine specialists in Kenya.
While navigating through multiple committees and political issues, the group was creating many Kenyan “firsts.” It was Moi University Faculty of Medicine’s first postgraduate program. And it was the first time the Kenyan medical system had worked with family medicine as a concept. “It was daunting,” Dahlman says.
But it worked. The program’s first three residents are graduating this year. “It’s still not a well-known specialty, but we’re giving it a chance to make a difference,” Dahlman says.
Dahlman and his wife, Kate Dahlman, who has helped establish a registered nurse training program at Kijabe Hospital, are now back in Minnesota, working and living in Grand Marais through the end of the year as part of their African Inland Mission’s “home assignment” for rest and rejuvenation.
While Bruce Dahlman has brought medical expertise to Kenya, he also appreciates all he has learned from the Kenyans.
“There’s a lot that working among the poor does to mold character,” he says. “It can’t help but change the way you see the world and the ways America could improve as well.”